| Objective:To Preliminary summarize the Musculoskeletal Ultrasound Manifestations of Cervical Extensors of Adolescent Neck Pain patients. Investigate the correlation of the neck extensor muscles strain, cervical X-ray, clinical evaluation of neck pain and living habits. As well as summarize the roles neck extensor muscles play in the pathogenesis of Adolescent Neck Pain. In addition, make an objective evaluation for the contemporary importance of "injury of tendon and muscle lead to bone diseases" theory in Traditional Chinese Medicine. And Provide new ideas for the prevention and treatment of Adolescent Neck Pain in the further study.Method:This research is a cross-sectional study. Adolescent neck pain patients and healthy adolescent volunteers are investigated in Beijing. Then group them into neck pain group and control group. Collect the basic information, neck pain information and living habits information with questionnaire. Collect the extensor muscle and cervical spine information with musculoskeletal ultrasound and cervical X-ray, measure all the images with Digimizer software. Build a database of all the data with Epidata 3.1 software. Analyze the data with SAS 8.0 statistics software, such as frequency analysis, variance analysis and spearman correlation coefficient, et al.Result:1. Basic information76 of 77 adolescents were investigated with questionnaire form, excluded one case because of incomplete information. The neck pain group is composed of 23 males (39.0%) and 36 females (61.0%), which is 23.32±1.91 years old,166.10±7.29cm height,57.29±9.61kg weight and 20.66±2.32 body mass index in average. The control group is composed of 8 male and 9 female, which is 22.88±2.71 years old,171.41±8.27cm height,65.24±12.87kg weight and 22.01±2.78 body mass index in average. The education level of them range from high school diploma to Doctor degree,3 cases(3.95%) with high school diploma,26 cases (34.21%)with bachelor degree,46 cases with master degree(60.52%) and 1 case with doctor degree(1.32%).2. Correlation between neck extensor muscle and neck pain2.1 Musculoskeletal ultrasound characteristics of adolescent neck pain patients’ neck extensor muscleMeasure the thickness variation of splenius capitis and semispinalis capitis between rest position and isometric contraction position. Calculate the index of extensor muscle. Analyze the difference between neck pain group and control group by Nonparametric test (the data are not normal). Statistics show that the difference is statistically significant (P<0.01).2.2 Correlation between neck extensor muscle and neck painInvestigate the neck pain group’s neck pain information with Northwick Neck Pain Questionnaire (NPQ) and McGill Pain Questionnaire (MPQ). Analyze the correlation between NPQ, MPQ and extensor muscle index by spearman coefficient. Statistics show that both NPQ and MPQ had negative correlation with extensor muscle index. The correlation coefficients were-0.82(NPQ) and-0.84(MPQ).3. Correlation between neck extensor muscle and cervical X-rayMeasure the cervical curvature and cervical vertebrae slip with cervical X-ray. Analyze the characteristics with variance analysis and Chi-square analysis. Analyze the correlation between cervical curvature and extensor muscle index.3.1 Characteristics of adolescent neck pain patients’ cervical X-rayStatistics show that there is a significant difference between neck pain group and control group in cervical curvature (P<0.01). The neck pain group’s cervical curvature is far more straighten than control group. And there are no significant differences between neck pain group and control group in vertebral slip.3.2 Correlation between cervical curvature and neck muscle indexStatistics showed that cervical curvature have positive correlation with extensor muscle index. The correlation coefficient is 0.54. In neck pain group, the correlation coefficient of cervical curvature is 0.31. In control group, the correlation coefficient of cervical curvature is 0.78.4. Correlation between neck pain and living habits4.1 Correlation between extensor muscle index and living habitsAnalyze the correlation between five kinds of living habits and extensor muscle index by spearman coefficient. Statistics show that there is a negative correlation between daily cellphone using time and extensor muscle index (the correlation coefficient is -0.78), and a positive correlation between daily exercise time and extensor muscle index (the correlation coefficient is 0.53). In neck pain group, the correlation coefficient between daily cellphone using time, daily exercise time and extensor muscle index each are -0.64 and 0.51. In control group, the correlation coefficient between daily cellphone using time and extensor muscle index is -0.68. There is no correlation between other data.4.2 Correlation between cervical curvature and living habitsAnalyze the correlation between five kinds of living habits and cervical curvature by spearman coefficient. Statistics show that cervical curvature have negative correlation with daily cellphone using time, the correlation coefficient is -0.53. And there is a positive correlation with daily exercise time and cervical curvature, the correlation coefficient is 0.30. In neck pain group, there is a negative correlation between daily cellphone time and cervical curvature, the correlation coefficient is -0.32. In control group, cervical curvature have a positive correlation with daily exercise time, the correlation coefficient is 0.62. And a negative correlation with daily cellphone time, the correlation coefficient is -0.66. There is no correlation between other data.Conclusion:1. Adolescent neck pain patients’ neck extensor muscles expand less than healthy adolescents’ in musculoskeletal ultrasonography.2. Neck extensor muscles strain play an important role in adolescent neck pain and cervical curvature disorders.3. The neck extensor muscle strain and cervical curvature straight are closely related to unhealthy living habits, such as cellphone overuse and lack of exercise. |
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